Speaker Request Form

Note:  Required fields are denoted with a red asterisk (*).

Contact Information
Contact Name
*
Email
*
Primary Phone
()     -  *
Other Phone
()     - 
Organization/Venue
*
County:
               
               
Event Information
Please provide preferred date(s) and time(s) when you would like to schedule event(s).
Date(s)
*
Time(s)
*

How many will be attending?    

Where will the event be held?
Address
*
Address 2
City
State
Zip Code

Topics Interested in:
     See Educational Presentations brochure for topic descriptions and more details.


Note: To request a certain series subtopic please mention it in the form comments.

Accessing Aging Services
     * Caring for a loved one? Learn about resources and services that can help older adults and their family and friends assisting them with everyday living.

Planning Ahead
     1. Having the Conversation
     2. Important Documents
     3. Paying for Care with Medicare and Medicaid
     4. Housing Choices
     5. After a Death
     6. If you are a Veteran

Navigating Healthcare
     1. Interacting with Healthcare Providers
     2. In the Hospital Setting
     3. Palliative Vs. Hospice Care
     4. Finding and Managing Care At Home
     5. Finding and Managing Care in a Long Term Care Facility

Nuts and Bolts of Care
     1. Moving, Lifting and Transferring
     2. Managing Medications
     3. Common Equipment and their Use
     4. Adapting the Home

Preventing Burnout
     1. Caregiving over the Holidays
     2. Commons Signs of Burnout
     3. Strategies for Treating and Preventing Burnout
     4. Common Family Dynamic
     5. Challenging Care Situations

Dementia
     1. What do we mean by dementia?
     2. As the brain deteriorates-What stays and what goes?
     3. Managing Common Behaviors: Wandering, Bathing, Toileting, Sleeping, Eating

























If you are requesting more than one event please specify in comments section below.
Comments:
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